MARC R DEJONG MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****13

License Status

NOT RENEWED

Business

First Name

MARC

Middle

Last Name

DEJONG

Suffix

Business Name

MARC R DEJONG MD

Original Issue Date

06/21/2012

Effective Date

06/21/2012

Expiration Date

07/31/2014

City

BELLEVILLE

State

Zip

62226

County

SAINT CLAIR

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020